MULTIPLE SCLEROSIS: 2 very first symptoms that predict the long-term prognosis

The studyled by Dr. João Pedro F. Gonçalves of the University of Bahia (Brazil), followed 195 patients with MS, focusing on their symptoms at the onset of the disease and their later functional outcomes. The study used the Expanded Disability Status Scale (EDSS) to assess disability in MS patients. This follow-up revealed that:

• patients who experience blurred vision or sphincter dysfunction when first diagnosed with MS are at increased risk of more severe disability over time;
• these same patients have a 20% increased risk of poor functional outcomes;
• patients with sphincter dysfunction have a 25% increased risk of severe disability;
• In contrast, and in contradiction with the findings of previous research, symptoms such as acute paralysis and hypoesthesia are not predictive of worse long-term outcomes.

What explanations, what mechanisms underlie the progression of MS? Why do visual disturbances and sphincter symptoms herald a less favorable disease course? Researchers suggest that these symptoms could indicate more extensive initial lesions of the central nervous system or reflect a different subtype of MS with more severe long-term consequences, and therefore justifying more aggressive early treatment.

• The study therefore raises the question of more personalized treatment for these patients: should patients with these specific symptoms be quickly referred to more intensive therapies? What role could emerging biomarkers play in conjunction with these clinical indicators to further refine the accuracy of prognosis?
• The study also highlights the complex interplay between different MS symptoms and their impact on patients’ quality of life. While some symptoms like acute paralysis may seem more severe at first, less obvious problems like blurred vision or bladder dysfunction actually appear to be better predictors of long-term complications.

“It will therefore be a question of “prioritizing” the management of symptoms in MS care,”

write the authors.

This work, by already identifying predictive symptoms of disability, from the start of the disease, are already committed to intervening earlier and in a more personalized manner to try to modify the progression of the disease.